| NPI | 1932283637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC009266) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 3537) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-02-06 |